Vitamin D testing: new targeted guidelines stem the overtesting tide

January 18, 2016

Med J Aust 2016; 204 (1): 18.

doi:10.5694/mja15.00497

Author: Steven C Boyages

Bilinski and Boyages have previously reported that the frequency of vitamin D testing had risen dramatically in Australia between 2000 and 2010.1,2 Further, testing did not translate to improved health outcomes.3 Since that report,1 Medicare Benefits Schedule (MBS) expenditure on vitamin D testing rose from $109.0 million in the 2009–10 financial year to $151.1 million in 2012–13, falling slightly in 2013–14 to $143.1 million.

An MBS review for vitamin D testing in 2014 recommended targeted testing for high-risk groups only, and against population screening.3 High-risk patients include those with osteoporosis, osteomalacia, disorders of calcium and parathyroid hormone, malabsorption, chronic renal disease, patients with darker pigmented skin or reduced sun exposure, those under 16 years of age and patients taking drugs known to reduce vitamin D levels. Five new Medicare item numbers (66833, 66834, 66835, 66836 and 66837) were introduced in November 2014 to replace the two previous numbers (66608 and 66609) and improve quality use of testing. This report analyses data from the Medicare statistical reporting tool for the first 8 months (November 2014 to June 2015) since the introduction of the new MBS numbers and guidelines.